Zespół napięcia przedmiesiączkowego

Zespół napięcia przedmiesiączkowego
Epidemiologia

Zespół napięcia przedmiesiączkowego (ZNP) dotyka około 47,8% kobiet w wieku reprodukcyjnym globalnie (95% CI: 32,6-62,9), z różnicami geograficznymi – od 12% we Francji do 98% w Iranie. Objawy somatyczne i psychologiczne pojawiają się w fazie lutealnej i ustępują po rozpoczęciu miesiączki. Około 20-32% kobiet doświadcza ZNP w stopniu wpływającym na codzienne funkcjonowanie, a 2-5% spełnia kryteria przedmiesiączkowego zaburzenia dysforycznego (PMDD), które jest cięższą formą ZNP z dominującymi objawami emocjonalnymi i behawioralnymi. Czynniki ryzyka obejmują otyłość (BMI ≥30 zwiększa ryzyko trzykrotnie, a każdy wzrost BMI o 1 kg/m² podnosi ryzyko o 3%), palenie tytoniu (OR 2,5 dla objawów psychologicznych), dietę wysokokaloryczną oraz doświadczenia traumatyczne i stres. ZNP jest częstsze u kobiet z zaburzeniami nastroju i lękowymi, a także u studentek, u których częstość sięga 71,9% w Polsce i nawet do 91,8% w Turcji. Objawy ZNP znacząco obniżają jakość życia, wydajność w pracy i nauce oraz wiążą się z wyższą absencją i kosztami medycznymi.

Diagnostyka ZNP opiera się na obecności co najmniej jednego objawu fizycznego i psychologicznego pojawiającego się minimum 5 dni przed miesiączką i ustępującego do 4 dni po jej rozpoczęciu, utrzymującego się przez co najmniej 3 cykle i wpływającego na funkcjonowanie pacjentki. PMDD wymaga spełnienia kryteriów DSM-5, w tym co najmniej 5 objawów, z których jeden musi być afektywny (np. wahania nastroju, drażliwość). Częstość PMDD wynosi 3-8% populacji kobiet w wieku reprodukcyjnym. ZNP i PMDD stanowią istotne wyzwanie zdrowia publicznego ze względu na ich wpływ na zdrowie psychiczne, ryzyko samobójstw oraz obciążenie ekonomiczne związane z absencją i obniżoną produktywnością. Wczesna edukacja, zwiększenie świadomości wśród personelu medycznego i pacjentek oraz odpowiednie zarządzanie farmakologiczne i niefarmakologiczne są kluczowe dla poprawy jakości życia kobiet dotkniętych tymi zaburzeniami.

Epidemiologia zespołu napięcia przedmiesiączkowego (ZNP)

Zespół napięcia przedmiesiączkowego (ZNP) to powszechny problem zdrowotny dotykający kobiety w wieku reprodukcyjnym, charakteryzujący się objawami somatycznymi i psychologicznymi występującymi w fazie lutealnej cyklu miesiączkowego, które ustępują w ciągu kilku dni po rozpoczęciu miesiączki. Objawy te mogą znacząco wpływać na jakość życia, funkcjonowanie społeczne i ekonomiczne kobiet.¹²

Globalna częstotliwość występowania ZNP

Według metaanalizy obejmującej 17 badań, zbiorcza częstość występowania ZNP na świecie wynosi 47,8% (95% CI: 32,6-62,9) kobiet w wieku reprodukcyjnym.¹² Szacuje się, że około 20-32% kobiet w okresie przedmenopauzalnym doświadcza ZNP w stopniu, który wpływa na ich codzienne życie.¹ Natomiast wśród wszystkich kobiet w wieku reprodukcyjnym, około 30-40% odczuwa objawy syndromu.¹

Badania epidemiologiczne wskazują, że około 80-90% kobiet doświadcza przynajmniej jednego objawu ZNP w ciągu swojego życia.¹² Z tej grupy około 20-30% spełnia kryteria diagnostyczne ZNP, natomiast 2-5% kobiet doświadcza bardzo nasilonych objawów spełniających kryteria przedmiesiączkowego zaburzenia dysforycznego (PMDD).¹²

Zróżnicowanie geograficzne w występowaniu ZNP

Częstość występowania ZNP wykazuje znaczne zróżnicowanie geograficzne. Najniższą częstość odnotowano we Francji – 12% (95% CI: 11-13), a najwyższą w Iranie – 98% (95% CI: 97-100).¹² W międzynarodowym badaniu obejmującym 7226 kobiet z Europy, Ameryki Południowej i Azji stwierdzono, że częstość występowania objawów ZNP jest podobna we wszystkich krajach i regionach, jednak kobiety w niektórych krajach, takich jak Pakistan, były mniej zaznajomione z terminem ZNP w porównaniu z kobietami europejskimi.¹²

Badania przeprowadzone w różnych krajach wykazały następującą częstość występowania ZNP wśród studentek uniwersytetów: 33,82% w Chinach, 37% w Etiopii, 39,9% na Tajwanie, 65% w Egipcie, 72,1% do 91,8% w Turcji i 79% w Japonii.¹ W Polsce częstość występowania ZNP wśród studentek uniwersytetów szacuje się na około 71,9%.¹

Wpływ wieku na występowanie ZNP

ZNP może występować w dowolnym momencie życia reprodukcyjnego kobiety, od menarche do menopauzy.¹ Starsze nastolatki zwykle mają bardziej nasilone objawy niż młodsze.¹ Kobiety w czwartej dekadzie życia są najbardziej narażone na ciężkie objawy ZNP.¹² Szacuje się, że co najmniej 20% nastolatek doświadcza umiarkowanych do ciężkich objawów ZNP.¹

Duże badanie obejmujące ponad 3500 kobiet wykazało, że częstość występowania umiarkowanego do ciężkiego ZNP związanego z nastrojem wynosiła 10,7% u kobiet w wieku 15-24 lat, 8,6% u kobiet w wieku 25-34 lat, 11,2% u kobiet w wieku 35-44 lat i 10,8% u kobiet w wieku 45-54 lat.¹ Inne badanie przekrojowe wykazało, że objawy przedmiesiączkowe były mniej powszechne u kobiet w wieku 36-44 lat w porównaniu z młodszymi kobietami.²

Czynniki ryzyka zespołu napięcia przedmiesiączkowego

Identyfikacja czynników ryzyka ZNP jest kluczowa dla zapobiegania objawom i zmniejszenia wpływu zespołu na życie kobiet.¹

Czynniki fizyczne i środowiskowe

Dwa znane czynniki ryzyka ZNP to otyłość i palenie tytoniu. Badania wykazały, że kobiety z wskaźnikiem masy ciała (BMI) wynoszącym 30 lub więcej są prawie trzykrotnie bardziej narażone na ZNP niż kobiety bez otyłości.¹ Zaobserwowano silną liniową zależność między BMI a ryzykiem wystąpienia ZNP – każdy wzrost BMI o 1 kg/m² wiązał się ze znaczącym 3% wzrostem ryzyka ZNP.¹

Kobiety palące papierosy są ponad dwukrotnie bardziej narażone na cięższe objawy ZNP.¹ Wieloczynnikowa analiza regresji logistycznej wykazała, że status palenia był związany ze zwiększonym ryzykiem zgłaszania objawów psychologicznych (OR 2,5, 95% CI 1,1-5,8; p < 0,05) i objawów behawioralnych (OR 2,2, 95% CI 1,0-4,9; p < 0,05).¹

Spożywanie produktów o wysokiej zawartości kalorii, tłuszczu, cukru i soli wiązało się ze zwiększonym ryzykiem zgłaszania objawów fizycznych (OR 3,2, 95% CI 1,4-7,3; p < 0,05).¹

Czynniki psychospołeczne

Doświadczenia życiowe mogą być również czynnikiem ryzyka ZNP. Wyniki dużego badania podłużnego przeprowadzonego przez Bertone-Johnson i wsp. sugerowały, że doświadczenie przemocy (emocjonalnej, seksualnej lub fizycznej) we wczesnym okresie życia naraża kobiety na większe ryzyko ZNP w środkowych i późnych latach reprodukcyjnych.¹

Wyższe poziomy postrzeganego stresu i wyższe wyniki „codziennych utrapień” zostały zidentyfikowane jako czynniki ryzyka ZNP w badaniach populacyjnych.¹ Kobiety, które przytyły lub doświadczyły stresującego wydarzenia w ciągu ostatniego roku, są bardziej narażone na diagnozę ZNP.¹

Badania nad bliźniakami znacząco przyczyniły się do danych związanych z możliwymi czynnikami genetycznymi w ZNP, sugerując komponent dziedziczny.¹

Współistniejące problemy zdrowotne

Kobiety z innymi problemami zdrowotnymi są bardziej narażone na ZNP.¹ Obecne zaburzenia nastroju i lękowe lub historia zaburzeń nastroju lub lękowych są powszechne u kobiet z ZNP.²

Po dostosowanej analizie ZNP był bardziej rozpowszechniony wśród osób uczęszczających na 1/2 semestr studiów (współczynnik częstości [PR] 1,44; 95% CI 1,14-1,80), tych, które spożywały alkohol w ciągu ostatnich 30 dni (PR 1,23; 95% CI 1,04-1,47) i tych, które miały depresję (PR 1,49; 95% CI 1,30-1,71).¹

Wpływ ZNP na życie kobiet

ZNP wpływa na jakość życia kobiet, ich wydajność ekonomiczną i społeczną.¹ Około 23-31% kobiet w wieku reprodukcyjnym doświadcza ZNP w stopniu, który wpływa na ich codzienne życie.¹

Wpływ na edukację i pracę

Studentki uniwersytetów są najbardziej dotknięte ZNP.¹ Wskaźnik ZNP jest uważany za wysoki w tej populacji i niekorzystnie wpływa na ich życie i wyniki w nauce.¹

ZNP jest związany z wyższymi wskaźnikami nieobecności w pracy, wyższymi wydatkami medycznymi i niższą jakością życia związaną ze zdrowiem.¹ Kobiety z ZNP mają wyższe wskaźniki nieobecności w pracy, wyższe wydatki medyczne i niższą jakość życia związaną ze zdrowiem.¹

W badaniu przeprowadzonym na ponad 4000 kobiet z 19 różnych krajów stwierdzono, że kobiety z umiarkowanymi do ciężkich objawami przedmiesiączkowymi wykazywały zwiększoną absencję i zmniejszoną produktywność w pracy.¹

Wpływ na zdrowie psychiczne

ZNP jest związany z wysokimi wskaźnikami samobójstw i wypadków, wskaźnikami nieobecności w pracy i szkole, słabymi wynikami w nauce i ostrymi problemami psychiatrycznymi.¹

Ponad połowa (53,8%) studentek zgłosiła, że ZNP pogorszył ich wydajność/produktywność w szkole/pracy i koncentrację, a 49,2% zgłosiło, że ZNP pogorszył ich aktywność w życiu społecznym.¹

Objawy ZNP mogą być związane z upośledzeniem wyników akademickich, w tym słabymi ocenami i nieobecnościami. To zaburzenie u młodych kobiet jest znaczącym problemem zdrowia publicznego, ponieważ stwierdzono zwiększoną częstość występowania zaburzeń depresyjnych i lękowych u kobiet cierpiących na ZNP, co mogłoby pośrednio obciążyć społeczeństwo ekonomicznie w postaci nieobecności w pracy, częstych hospitalizacji i samobójstw.¹

Różnice między ZNP a przedmiesiączkowym zaburzeniem dysforycznym (PMDD)

ZNP jest ogólnym terminem odnoszącym się do objawów fizycznych, emocjonalnych i behawioralnych występujących 1-2 tygodnie przed miesiączką i ustępujących wraz z jej rozpoczęciem. Natomiast PMDD jest cięższą formą ZNP z bardziej restrykcyjnymi kryteriami i przewagą objawów emocjonalnych i behawioralnych.¹

Kryteria diagnostyczne

PMDD, zgodnie z definicją Amerykańskiego Towarzystwa Psychiatrycznego (APA) w Podręczniku Diagnostycznym i Statystycznym Zaburzeń Psychicznych, Piąta Edycja (DSM-5), można odróżnić od ZNP przez obecność co najmniej pięciu objawów, w tym jednego objawu afektywnego, takiego jak wahania nastroju, drażliwość i/lub depresja.¹²

PMDD jest klasyfikowane w DSM-5-TR jako choroba psychiczna. Kryteria PMDD wymagają, aby kobieta doświadczała co najmniej 5 z 11 objawów poznawczo-afektywnych, behawioralnych i fizycznych w ostatnim tygodniu fazy lutealnej, które ustępują wraz z lub blisko początku miesiączki. Objawy muszą również ustąpić po miesiączce i nie mogą stanowić zaostrzenia innego zaburzenia psychiatrycznego.¹

Różnice w występowaniu

Częstość występowania PMDD w populacji wynosi około 3-8% kobiet w wieku reprodukcyjnym, podczas gdy ZNP dotyka 20-30% kobiet.¹²

Badania epidemiologiczne wskazują, że nawet 80% osób w Stanach Zjednoczonych doświadcza emocjonalnych, behawioralnych lub fizycznych objawów przedmiesiączkowych. Między 3% a 8% osób spełnia kryteria diagnostyczne PMDD.¹

Na całym świecie PMDD dotyka 38% osób w wieku reprodukcyjnym, nakładając ogromne obciążenie na osoby dotknięte, ich rodziny i system opieki zdrowotnej.¹

Ciężkość objawów

ZNP jest ogólnie zarządzalny i minimalnie upośledza funkcjonowanie psychospołeczne, podczas gdy PMDD uznawane jest za ciężką formę ZNP z bardziej restrykcyjnymi kryteriami i przewagą objawów emocjonalnych i behawioralnych.¹

PMDD jest zaburzeniem depresyjnym, które wpływa na funkcjonowanie, jest mniej powszechne i jest wymienione w Podręczniku Diagnostyczno-Statystycznym Zaburzeń Psychicznych 5 (DSM-5), który obejmuje bardziej dotkliwe objawy ZNP.¹²

Najnowsze badania wskazują, że około 1,6% kobiet i dziewcząt ma objawowe PMDD, co odpowiada około 31 milionom kobiet i dziewcząt na całym świecie.¹

Wyższy odsetek – 3,2% – miał tymczasowe diagnozy, w których podejrzewa się schorzenie, ale objawy nie były mierzone przez dłuższy okres czasu, aby spełnić kryteria potwierdzonej diagnozy.¹

Trendy w epidemiologii ZNP

Metaregresja wykazała rosnący trend w zgłaszanej częstości występowania ZNP między 1996-2011, chociaż korelacja nie jest statystycznie istotna.¹

Zmiany w czasie

Trwałość i ciężkość objawów zwykle wahają się. Jedno badanie wykazało, że tylko 36% kobiet, którym zdiagnozowano ZNP, nadal spełniało kryteria diagnostyczne rok później.¹ Inne badanie wykazało, że około 36% kobiet miało ZNP, a obserwacja kontrolna wykazała, że kobiety te nadal spełniały kryteria diagnostyczne ZNP po 1 roku.¹

Wpływ wieku i czynników życiowych

Objawy ZNP mogą się nasilać w miarę wchodzenia w późne lata 30. lub 40. i zbliżania się do menopauzy oraz w okresie przejściowym do menopauzy, zwanym perimenopazą.¹

ZNP ustępuje całkowicie w menopauzie, gdy kobieta nie ma już okresu.¹²

Przeciętnie kobiety w wieku 30 lat są najbardziej narażone na ZNP.¹

Metody badania epidemiologii ZNP

Prawdziwa częstość występowania ZNP jest trudna do określenia z powodu samoistnego leczenia, różnic w dostępności i dostępie do opieki medycznej, definicji kryteriów diagnostycznych i praktyk kulturowych.¹

Wyzwania metodologiczne

Częstość występowania ZNP i PMDD w populacji została zawyżona z powodu niepowodzenia w zastosowaniu ścisłych kryteriów diagnostycznych. Oszacowania nawet do 80% były zgłaszane dla ZNP, w oparciu o włączenie kobiet, które mają jakąkolwiek formę przedmiesiączkowego nastroju lub objawów fizycznych.¹²

Gdy stosuje się ścisłe kryteria włączenia, szacunki dla ZNP wynoszą około 20-30%, a dla PMDD 2%, co ilustrują trzy badania społeczne, które wykorzystały prospektywne oceny do ustalenia diagnozy.¹²

Narzędzia diagnostyczne

Diagnoza ZNP opiera się na rodzaju objawów i czasie ich pojawienia się w cyklu miesiączkowym. Aby powiązać objawy z ZNP, co najmniej jeden objaw fizyczny i psychologiczny powinien wystąpić pięć dni przed miesiączką, objawy te powinny ustąpić cztery dni po miesiączce, powinny trwać przez co najmniej trzy cykle miesiączkowe i powinny niekorzystnie wpływać na codzienne czynności i relacje międzyludzkie.¹

Częstość występowania ZNP, główna zmienna wynikowa w jednym z badań, została wykryta zgodnie z kryteriami diagnostycznymi zaproponowanymi przez Amerykańskie Kolegium Położników i Ginekologów (ACOG). Objawy muszą ustąpić w ciągu 4 dni od rozpoczęcia miesiączki, bez żadnego nawrotu aż do co najmniej 13 dnia cyklu i być obecne w przypadku braku jakiejkolwiek terapii farmakologicznej lub spożywania alkoholu.¹

Jeśli objawy wydają się ciężkie i niepełnosprawne, należy rozważyć przedmiesiączkowe zaburzenie dysforyczne (PMDD), które jest często niedodiagnozowane, i poprosić pacjentki o zapisywanie objawów przez 2 cykle; do diagnozy PMDD muszą być spełnione kryteria kliniczne.¹

Kraj/Region	Częstość występowania ZNP (%)	Źródło
Globalnie (metaanaliza)	47,8% (95% CI: 32,6-62,9)	¹
Francja	12% (95% CI: 11-13)	¹
Iran	98% (95% CI: 97-100)	¹²
Chiny (studentki)	33,82%	¹
Etiopia (studentki)	37%	¹
Tajwan (studentki)	39,9%	¹
Egipt (studentki)	65%	¹
Turcja (studentki)	72,1% – 91,8%	¹
Japonia (studentki)	79%	¹
Polska (studentki)	71,9%	¹
Liban (studentki)	62,5%	¹
Tajlandia (uczennice)	29,8% (95% CI, 24,5%-35,4%)	¹

Wpływ ZNP na zdrowie publiczne

ZNP jest znaczącym problemem zdrowia publicznego ze względu na jego wysoką częstość występowania i wpływ na jakość życia kobiet.¹

Koszty ekonomiczne

Oprócz ingerencji w jakość życia kobiety, ZNP i PMDD mogą mieć zarówno bezpośrednie, jak i pośrednie konsekwencje ekonomiczne.¹

Stwierdzono, że ZNP ma znaczący wpływ na jakość życia kobiet związaną ze zdrowiem i może prowadzić do zmniejszonej produktywności w pracy i zwiększonych kosztów opieki zdrowotnej.¹

Stwierdzono, że diagnoza ZNP była związana z umiarkowanym wzrostem bezpośrednich kosztów medycznych i znacznym wzrostem kosztów pośrednich wynikających z nieobecności w pracy i niższej produktywności, gdy kobiety były w pracy.¹

Świadomość i edukacja

Częstość występowania ZNP jest znacząco wysoka na świecie i w naszym kraju. W związku z tym ważne jest zwiększenie świadomości pracowników służby zdrowia i kobiet na temat ZNP.¹

Pierwszym krokiem w zarządzaniu ZNP jest stworzenie świadomości poprzez edukację i doradztwo, nauczenie kobiet samobadania i praktyk samopomocy.¹

Większość (80%) kobiet wiedziała o ZNP, podczas gdy tylko (43,8%) wiedziała o PMDD. Najpowszechniejsze objawy afektywne i somatyczne wśród uczestników to drażliwość (74,6%) i wzdęcia brzucha (48,5%).¹

Mimo pozytywnej odpowiedzi uczestniczek na ZNP w badaniu, istnieje brak wiedzy na temat konieczności konsultacji z lekarzem lub szukania leczenia na ich objawy.¹

Zachowania związane z poszukiwaniem zdrowia i wiedza na temat ZNP wydają się być dość niskie wśród studentów, co wskazuje na potrzebę zapewnienia świadomości i położenia nacisku na zarządzanie objawami przedmiesiączkowymi zarówno farmakologicznie (jeśli jest to wymagane), jak i niefarmakologicznie.¹

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Materiały źródłowe

#1 Epidemiology of Premenstrual Syndrome (PMS)-A Systematic Review and Meta-Analysis Study
https://pmc.ncbi.nlm.nih.gov/articles/PMC3972521/
Premenstrual Syndrome (PMS) is a common health problem in women in reproductive age. The present study aimed to investigate the prevalence of PMS using meta-analysis method. This meta-analysis systematically reviewed the prevalence of PMS. Overall, 17 studies met our inclusion criteria. The pooled prevalence of PMS was 47.8% (95% CI: 32.6-62.9). The lowest and highest prevalence were reported in France 12% (95% CI: 11-13) and Iran 98% (95% CI: 97-100) respectively. Considering that different tools have been used in studies and many studies have been designed based on a limited sample, therefore, future research needs to consider the prevalence of PMS in different countries of world. The prevalence of PMS has been reported in 20 to 32 % of premenopausal and 30-40% of the reproductive female population. PMS affects women’s quality of life, economic and social performance. In other study, about 23-31 % of reproductive aged women experience PMS to a degree that affects their daily lives. The pooled prevalence of PMS was 47.8% (95% CI: 32.6-62.9). The prevalence of PMS has been studied in Asia in compared with other continents. Based the retrieved studies Iran has been the highest prevalence of PMS. The global prevalence of PMS is high and about half of women of reproductive age who experience this symptoms.
#1 Premenstrual Syndrome and Premenstrual Dysphoric Disorder | AAFP
https://www.aafp.org/pubs/afp/issues/2011/1015/p918.html
Premenstrual syndrome is defined as recurrent moderate psychological and physical symptoms that occur during the luteal phase of menses and resolve with menstruation. It affects 20 to 32 percent of premenopausal women. […] Up to 80 percent of women report one or more physical, psychological, or behavioral symptoms during the luteal phase of their menstrual cycle without experiencing substantial disruption to their daily functioning. PMS, in which mild to moderate symptoms affect some facet of the woman’s life, occurs in 20 to 32 percent of premenopausal women; the more severe symptoms of PMDD affect 3 to 8 percent of premenopausal women. […] However, the prevalence of PMDD varies substantially among studies, likely because of different study definitions for PMDD. Initially, PMS and PMDD appeared to be limited to women in Western cultures, but more recent studies have demonstrated symptoms suggesting that PMS and PMDD occur at similar rates internationally.
#1 Premenstrual syndrome (PMS) – Symptoms & causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780
Premenstrual syndrome (PMS) has a wide variety of signs and symptoms, including mood swings, tender breasts, food cravings, fatigue, irritability and depression. It’s estimated that as many as 3 of every 4 menstruating women have experienced some form of premenstrual syndrome. […] Symptoms tend to recur in a predictable pattern. […] For some, the physical pain and emotional stress are severe enough to affect their daily lives. Regardless of symptom severity, the signs and symptoms generally disappear within four days after the start of the menstrual period for most women. […] But a small number of women with premenstrual syndrome have disabling symptoms every month. This form of premenstrual syndrome (PMS) is called premenstrual dysphoric disorder (PMDD). […] If you haven’t been able to manage your premenstrual syndrome with lifestyle changes and the symptoms of PMS are affecting your health and daily activities, see your doctor.
#1 Epidemiology and pathogenesis of premenstrual syndrome and premenstrual dysphoric disorder – UpToDate
https://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder
EPIDEMIOLOGY […] Premenstrual dysphoric disorder (PMDD), as defined by the American Psychiatric Association (APA) Diagnostic and Statistical Manual, Fifth Edition (DSM-5), can be differentiated from premenstrual syndrome (PMS) by the presence of at least five symptoms, including one affective symptom, such as mood swings, irritability, and/or depression. […] The prevalence of PMS and PMDD in the population have been overestimated because of the failure to apply strict diagnostic criteria. Estimates as high as 80 percent have been reported for PMS, based upon the inclusion of females who have any form of premenstrual mood or physical symptoms. When one applies strict inclusion criteria, estimates for PMS are around 20 to 30 percent and 2 percent for PMDD, as illustrated by three community studies that used prospective ratings to determine the diagnosis.
#1 Epidemiology and pathogenesis of premenstrual syndrome and premenstrual dysphoric disorder – UpToDate
https://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder
PMS is described in diverse cultural settings, even among females who are not generally aware of the disorder. As an example, similar rates of the disorder are reported in Mediterranean countries, the Middle East, Iceland, Kenya, New Zealand, and Asia. The point prevalence of retrospectively reported symptoms range from 2.8 to 6.4 percent. In an international survey of 7226 females in Europe, South America, and Asia, the frequency of PMS symptoms is similar across countries and regions, but females in some countries, such as Pakistan, are less familiar with the term PMS when compared with European females. Symptoms that are most commonly reported are abdominal bloating, cramps, irritability, mastalgia, and joint and back pains.
#1 Premenstrual Syndrome – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK560698/
Female university students are affected the most by PMS. The rate of PMS is believed to be high among this population, and it adversely affects their life and academic performance. The prevalence of PMS among the university students of different countries are as follows; for example, 33.82% in China, 37% in Ethiopia, 39.9% in Taiwan, 65% in Egypt, 72.1% to 91.8% in Turkey, and 79% in Japan. […] This geographical difference in the prevalence of PMS may be attributed to disparities in genetic, dietary, and lifestyle factors among young adult females and also may be attributable to various community-adopted practices before and during menstruation.
#1 Prevalence of premenstrual syndrome and its association with psychosocial and lifestyle variables: a cross-sectional study from Palestine | BMC Women’s Health | Full Text
https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01374-6
Premenstrual Syndrome (PMS) is a very common problem with symptoms that can negatively affect normal daily life. This cross-sectional study aimed to investigate the prevalence of PMS symptoms and their relationship with psychosocial status and lifestyle of female students at An-Najah National University in Palestine. A sample of 398 female students was randomly selected to participate in the study. The 398 participants (100%) suffered from some kind of PMS symptoms; 398 (100%) had physical symptoms, 397 (99.7%) had psychological symptoms, and 339 (85.2%) had behavioral PMS symptoms. All PMS symptoms were significantly associated with student psychosocial status (p0.01). The findings of the study revealed a relatively high prevalence of PMS syndrome with a significant relationship with dietary habits and psychosocial status. Epidemiological data shows that 75% of women in reproductive age suffer from some PMS symptoms, while 3% to 8% reported extremely severe PMS symptoms. A study on PMS prevalence among different countries worldwide found that 47.8% (95% CI: 32.662.9) of women have PMS. Other several studies on the PMS prevalence in Middle Eastern countries had been conducted in the past 20 years. For instance, PMS percentages among university students were 71.9% in Palestine, 92.3% in Jordan, 80.2% in Egypt, and 63% in Lebanon. The reported physical and psychological symptoms occurring pre-menstrually are more than 100 symptoms. Common PMS symptoms include: mood swings, depression, irritability, abdominal cramps, headache, generalized pains, abdominal bloating, breast swollen and tenderness, and appetite changes. Literature on PMS shows that this problem overlooked in developing countries, including Palestine. There is an urgent need to collect data the PMS prevalence among young women in Palestine and find its effect on their health.
#1
https://link.springer.com/article/10.1007/s00737-022-01261-5
Premenstrual symptoms, including physical and mood symptoms, affect a large proportion of women worldwide. […] Data on premenstrual symptoms across nations and age groups is limited. […] Approximately 80% of women report experiencing at least one mood or physical symptom premenstrually. […] However, there is limited data on the occurrence of premenstrual symptoms across nations and by different age groups. […] Premenstrual syndrome (PMS) includes mild to moderate physical and/or mood symptoms and occurs in roughly 20% of women, while premenstrual dysphoric disorder (PMDD), at the severe end of the continuum, includes more impairing symptoms and is found in 3 to 8% of women. […] Premenstrual symptoms may occur at any point during the female reproductive years, from menarche to menopause.
#1 Premenstrual Syndrome: Practice Essentials, Pathophysiology and Etiology, Epidemiology
https://emedicine.medscape.com/article/953696-overview
Individual symptoms of PMS have been reported to affect as many as 90% of women of reproductive age sometime during their lives. An estimated 20-30% of women may meet criteria for PMS based on symptoms with 2-5% of women meeting symptomatic criteria for PMDD. […] Two known risk factors for PMS are obesity and smoking. Research reveals that women with a body mass index (BMI) of 30 or above are nearly three times as likely to have PMS than women who are not obese. Women who smoke cigarettes are more than twice as likely to have more severe PMS symptoms. […] Life experiences may also be a risk factor for PMS. The results of a large longitudinal study carried out by Bertone-Johnson et al suggested that the experience of abuse (emotional, sexual, or physical) in early life places women at higher risk for PMS in the middle-to-late reproductive years. […] PMS affects women with ovulatory cycles. Older adolescents tend to have more severe symptoms than younger adolescents do. Women in their fourth decade of life tend to be affected most severely. PMS resolves completely at menopause.
#1 PMS & PMDD – MGH Center for Women’s Mental Health
https://womensmentalhealth.org/specialty-clinics/pms-and-pmdd/
Premenstrual Syndrome, commonly referred to as PMS, is a broad term that typically refers to a general pattern of physical, emotional and behavioral symptoms occurring 1-2 weeks before and remitting with the onset of menses. PMS is common, affecting from 30-80% of women of reproductive age, though clinically significant PMS symptoms have been reported in 3-8% of patients. […] Epidemiologic studies have shown that premenstrual disorders may begin during the teen years. It has been reported that at least 20% of adolescents experience moderate to severe premenstrual symptoms. PMDD appears to be as common in teens as in older women, with various studies estimating that about 2%-6% of girls between the ages of 14 and 16 meet criteria for PMDD. […] PMDD affects 3-8% of women in their reproductive years, with symptoms usually emerging during a womanâs twenties. These symptoms may worsen over time; for example, it has been observed that some women may experience worsening premenstrual symptoms as they enter into menopause.
#1
https://link.springer.com/article/10.1007/s00737-022-01261-5
A large study of over 3500 women reported the prevalence of moderate to severe mood-based PMS as 10.7% in women aged 15-24, 8.6% in women aged 25-34, 11.2% in women aged 35-44, and 10.8% in women aged 45-54. […] However, another cross-sectional study found that premenstrual symptoms were less common in women ages 36 to 44 years, compared with younger women. […] In a meta-analysis assessing the prevalence of PMS in twelve countries, the highest prevalence was reported in Iran (98%) and the lowest prevalence was reported in France (12%). […] In a study of over 4000 women from 19 different countries, those with moderate to severe premenstrual symptoms showed increased absenteeism and decreased productivity at work. […] Among adolescents, at least 20% reported PMS symptoms associated with functional impairment.
#1 SciELO Brazil – Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil
https://www.scielo.br/j/rbgo/a/XwcjFFvbkNJj6fXsGFfnJ3g/
The association between lower educational levels and PMS has been described previously. […] The association of PMS with sociodemographic, reproductive, behavioral, nutritional, and health variables was evaluated. […] The study identified that almost half of the university students had PMS, and 11% had PMDD. […] The university students who were at the beginning of the course, who consumed alcohol as well as those who had a diagnosis of depression had a higher prevalence of premenstrual symptoms.
#1 Premenstrual Syndrome and Premenstrual Dysphoric Disorder as Centrally Based Disorders
https://www.mdpi.com/2673-396X/3/1/12
Behavioral risk factors, especially smoking and adiposity, are overrepresented in women with PMS/PMDD, confirming their link to emotional vulnerability. […] A strong linear relationship between body mass index (BMI) at baseline and risk of incident PMS, with each 1 kg/mÂ² increase in BMI associated with a significant 3% increase in PMS risk, was evident. […] Other proven risk factors include traumatic events, which greatly increased the odds of developing PMDD at follow-up. […] The co-occurrence with pathological manifestations displaying premenstrual exacerbations supports a common neuroendocrine etiology. […] Medical conditions such as anemia and endocrine disorders may mimic PMS/PMDD symptoms.
#1 Premenstrual Syndrome Is Associated with Dietary and Lifestyle Behaviors among University Students: A Cross-Sectional Study from Sharjah, UAE
https://www.mdpi.com/2072-6643/11/8/1939
However, no previous studies have investigated the prevalence of PMS and the association between PMS and dietary and lifestyle factors among university students in UAE. Thus, this study aimed to clarify the associations between PMS and dietary habits, lifestyle behaviors, and body composition variables as potential risk factors. […] The multiple logistic regression analysis showed that smoking status was associated with increased risk of reporting psychological symptoms (OR 2.5, 95% CI 1.1â5.8; p < 0.05) and behavioral symptoms (OR 2.2, 95% CI 1.0â4.9; p < 0.05), while high calorie/fat/sugar/salt foods intake was associated with increased risk of reporting physical symptoms (OR 3.2, 95% CI 1.4â7.3; p < 0.05). [...] The present study aimed to assess the prevalence and severity of PMS symptoms among a sample of university students, to identify associated dietary and lifestyle factors, and clarify the association between PMS and BFP or BMI. [...] This is the first study investigating PMS among female university students in UAE and highlighting the high prevalence rate of PMS in this population.
#1 Epidemiology and Etiology of Premenstrual Syndromes
https://www.medscape.org/viewarticle/553603
Population-based studies have not consistently found strong association between PMS and standard demographic risk factors such as education, income, employment, marital status, or number of children. […] Higher levels of perceived stress and higher „daily hassles” scores have been identified as risk factors for PMS by population-based studies. […] Studies of twins have significantly contributed to data related to possible genetic factors in PMS. […] A strong association between PMS and a body mass index 30 is reported in a recent population-based study. […] Women with other health problems are more likely to have PMS. […] Current mood and anxiety disorders or history of mood or anxiety disorders are common in women with PMS.
#1 Premenstrual Syndrome and Premenstrual Dysphoric Disorder | AAFP
https://www.aafp.org/pubs/afp/issues/2016/0801/p236.html
Premenstrual disorders affect up to 12% of women. […] The burden of disease can be high; women with PMS have higher rates of work absences, higher medical expenses, and lower health-related quality of life. […] In a study of 2,800 French women, about 12% met the diagnostic criteria for PMS, and 4% reported severe symptoms. […] The prevalence of PMS is not associated with age, educational achievement, or employment status. […] Fewer patients meet the more rigorous diagnostic criteria for PMDD; its prevalence is 1.3% to 5.3%. […] About 80% of women report at least one physical or psychiatric symptom during the luteal phase of their menstrual cycle; however, most do not report significant impairment in their daily life. […] Symptom persistence and severity tend to fluctuate. One study found that only 36% of women who were diagnosed with PMS continued to meet the diagnostic criteria one year later. […] Women who gained weight or had a stressful event in the past year are more likely to be diagnosed with PMS.
#1 SciELO Brazil – Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil
https://www.scielo.br/j/rbgo/a/XwcjFFvbkNJj6fXsGFfnJ3g/
The prevalence of PMS was 46.9% (95% confidence interval [CI] 44.0-49.8), and of PMDD, 11.1% (95% CI 9.3-13.0). […] More than 30% of the patients reported that the symptoms interfered in a moderate-to-severe way in their social and academic activities. […] After adjusted analysis, PMS was more prevalent in those who were attending the 1st/2nd semester of college (prevalence ratio [PR] 1.44; 95% CI 1.14-1.80), those who consumed alcohol in the last 30 days (PR 1.23; 95% CI 1.04-1.47), and those who had depression (PR 1.49; 95% CI 1.30-1.71). […] The identification of risk factors for PMS is essential to prevent symptoms and reduce the impact of the syndrome. […] The prevalence of PMS (46.9%) identified in the present study is consistent with that in the literature. […] The prevalence of PMDD (11.1%) was lower than that reported in a study conducted in the Northeast of Brazil, with health professionals and university students (16.5%).
#1 Prevalence, impacts and medical managements of premenstrual syndrome among female students: cross-sectional study in college of health sciences, Mekelle University, Mekelle, Northern Ethiopia | BMC Women’s Health | Full Text
https://bmcwomenshealth.biomedcentral.com/articles/10.1186/1472-6874-14-52
PMS is related to high suicide and accident rates, employment and school absentee rates, poor academic performance and acute psychiatric problems. […] The prevalence of PMS in general is high among health sciences students of Mekelle University with prevalence of 37.0%. […] Average number of days per each menses is found to affect the development of PMS and academic performance impairment is found to affect the use of treatment protocols for PMS.
#1 A Study on Premenstrual Syndrome among Female Students of a Private University of Delhi NCR
http://www.fortunejournals.com/articles/a-study-on-premenstrual-syndrome-among-female-students-of-a-private-university-of-delhi-ncr.html
The PMS symptoms could impact an individualâs interpersonal relationships, social interactions, occupational activities and productivity for her entire reproductive age life. Especially for young women, premenstrual symptoms can be related to academic performance impairments including poor grades and absenteeism. This disorder in young women is a significant public health problem, as increased incidence of depression and anxiety disorders were found in women suffering with PMS, which could economically burden the society indirectly in the form of absenteeism at work, frequent hospitalization and suicides. […] The majority (80%) of female participants knew about PMS while only (43.8%) knew about PMDD. The most common affective and somatic symptoms among participants were irritability (74.6 %) and abdominal bloating (48.5%). More than half (53.8 %) of the female participants reported PMS impaired their College/work efficiency/ productivity and Concentration and (49.2 %) reported PMS impaired their Social life activities. The majority (90%) of female participants think that PMS is an important issue that should be discussed but (40.8%) did nothing to relieve their premenstrual symptoms.
#1 Brazilian Journal of Psychiatry
http://bjp.org.br/details/122/en-US
Premenstrual syndrome (PMS) has several definitions, and its estimated prevalence ranges from 75% to 95%. Premenstrual Dysphoric Disorder (PMDD) is the most severe form of PMS with more restrictive criteria and a predominance of emotional and behavioral symptoms. PMDD requires at least 5 of the 11 symptoms specified in the DSM-IV-TR Appendix B (Criteria Sets and Axes Provided for Further Study). In contrast with PMS, PMDD affects only 3 to 9% of women. Previous studies have focused on the lifetime comorbidity of mood disorders, anxiety disorders, and personality disorders in women with PMS (PMS+) or PMDD (PMDD+). Compared to women at other phases of their menstrual cycle, those in the premenstrual period present higher rates of hospitalization, emergency treatment, and suicide attempts. Due to these regular relapses reported during the premenstrual phase, women may have a more severe expression and evolution of psychiatric disorders. Considering the gender differences in mood disorders, it is remarkable that BD women have a higher risk of postpartum mood episodes and pre-menopause. Mood disorders have the same prevalence prior to puberty. When the increase in sex hormones becomes evident, the female-to-male ratio of unipolar depression shifts to 2:1. Therefore, it is possible that steroid hormones might be involved. However, in relation to Bipolar Depression, the polarity of previous episodes is a controversial issue. Some researchers found that women have more depressive episodes than men, but others found no difference. Researchers have been studying the relationship between neurotransmitters, female gonadal hormones, and the emergence and pattern of symptoms of premenstrual dysphoria. Women with bipolar disorder have a higher risk of postpartum mood episodes. At the same time, women with PMDD are more likely to experience mood disorders. Estrogen and progesterone fluctuation across the menstrual cycle can modulate affective symptoms through their actions in the CNS. It has been demonstrated that estrogen has a profound impact on mood and on the trimonoaminergic neurotransmitter system, GABA, and glutamate, which are involved in the pathophysiology of depression. It is currently accepted that women with premenstrual complaints differ from controls not with respect to ovarian function, but with respect to how responsive the target organs are to the influence of gonadal steroids. The association of PMS with axis I comorbidity and its mechanism was extensively studied in the latter part of the twentieth century, and there has been a resurgence of publications on this topic since 2007. Many researchers have studied the influence of menstrual cycle phases on mood in BD patients; however, the results vary. The aim of this article is to evaluate the comorbidity of PMS or PMDD with Bipolar Disorder (BD), to identify variables requiring further investigation and to remind physicians that special care is required for diagnosis and therapy. Therefore, this is the first systematic review of the association between BD and PMS/PMDD.
#1 Premenstrual syndrome and dysphoric disorder – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/419
PMS is not classified as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). The American College of Obstetricians and Gynecologists defines PMS as the cyclic recurrence of symptoms that occur in the luteal phase of the menstrual cycle, are variable in intensity and effect on daily life, and cease shortly after the onset of menstruation. […] PMDD, the more severe form of the disorder, is classified in the DSM-5-TR as a mental illness. The criteria for PMDD require that the woman experience at least 5 of 11 cognitive-affective, behavioural, and physical symptoms during the final week of the luteal phase that resolve with or near the onset of menses. Symptoms must also remit post-menses, and not represent an exacerbation of another psychiatric disorder.
#1 Premenstrual Dysphoric Disorder: Practice Essentials, Background, Pathophysiology and Etiology
https://emedicine.medscape.com/article/293257-overview
Epidemiologic studies indicate that as many as 80% of individuals in the United States experience emotional, behavioral, or physical premenstrual symptoms. Between 3% and 8% of individuals meet the diagnostic criteria for PMDD. […] Worldwide, PMDD affects 38% of individuals in their reproductive years, imposing an enormous burden on those affected, their families, and the healthcare system. A study from India reported a frequency of 6%. […] A population-based sample from Switzerland, covering the entire reproductive age range, found that 3% of the sample population fulfilled criteria for PMDD. […] A cross-sectional study of Nigerian medical students showed that 36% of the respondents met the criteria for the diagnosis of PMDD. […] Apparently, individuals in their late thirties to early forties are most vulnerable to experiencing PMDD. Although premenstrual clinics are reported to be almost exclusively attended by White individuals, community-based studies found no difference between Black and White individuals with respect to the prevalence or severity of premenstrual symptoms.
#1 PMT, PMS and PMDD: is there a difference? – O&G Magazine
https://www.ogmagazine.org.au/20/3-20/pmt-pms-and-pmdd-is-there-a-difference/
It has long been recognised that many women experience a predictable, cyclic pattern of moliminal symptoms, which begin in the late luteal phase of the menstrual cycle and end shortly after menstruation begins. […] PMS is the same thing. However, many argue that the latter label better describes the symptom cluster, with the term syndrome de-emphasising the emotional and psychological symptoms implied in the term tension. Overall, diagnostically, it is a loose and informal label, as it only requires one or two symptoms to qualify and is reported to be experienced by up to 50 per cent of women globally. […] While PMS is generally manageable and minimally impairs psychosocial functioning, it has been recognised that three to eight per cent of women experience multiple symptoms that can significantly affect their quality of life and daily interpersonal and occupational functioning, to the point of transient impairment.
#1 Premenstrual syndrome mechanism in the brain | 2021, Volume 7 – Issue 2 | Demiroglu Science University Florence Nightingale Journal of Medicine
https://journalmeddbu.com/full-text/250
Premenstrual dysphoric disorder is a depressive disorder that affects functionality, is less common, and is listed in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5), which includes more severe PMS symptoms. […] The etiology of PMS is associated with cognitive and psychosocial learning theories. […] The factors leading to CNS malfunctions in PMS have not been entirely understood. Many symptoms of PMDD, on the other hand, are comparable to psychiatric conditions involving the serotonergic system, and the links between the serotonergic system and progesterone have focused researchers attention on serotonergic regulation. […] The involvement of the CNS in PMS is becoming clear due to an increase in brain imaging studies. […] The changing topology of the brain concerning pain is suggested to contribute to the understanding of the neurological mechanism of PMS. […] Studies provide implications for increased cerebellar activity and decreased GABA-mediated inhibition during the symptomatic luteal phase.
#1 New data shows prevalence of Premenstrual Dysphoric Disorder | University of Oxford
https://www.ox.ac.uk/news/2024-01-30-new-data-shows-prevalence-premenstrual-dysphoric-disorder
Around 1.6% of women and girls have symptomatic Premenstrual Dysphoric Disorder (PMDD), according to a new review of global studies published in the Journal of Affective Disorders. […] The data suggested around 1.6% did equivalent to around 31 million women and girls globally. […] A higher proportion – 3.2% – had provisional diagnoses, where the condition is suspected but symptoms had not been measured for a sustained period of time to meet criteria for confirmed diagnosis. […] Dr Reilly, who is a Medical Research Council (MRC) Clinical Research Training Fellow in the Department of Psychiatry at Oxford University and Specialist Registrar at the National Female Hormone Clinic, Maudsley Hospital, says the proportion of those affected could be higher than 1.6%. […] 'Because diagnostic criteria is so strict, this is likely an underestimation of the lifetime prevalence of PMDD, and many more women and girls may be undiagnosed.
#1 Epidemiology of Premenstrual Syndrome (PMS) – A Systematic Review and Meta-Analysis Study | PDF | Premenstrual Syndrome | Meta Analysis
https://www.scribd.com/document/589379861/A-D-M-K-S-A-D-Sattar-K
Epidemiology of Premenstrual Syndrome (PMS) – A Systematic Review and Meta-Analysis Study. The document analyzes the prevalence of premenstrual syndrome (PMS) through a systematic review and meta-analysis of studies. It finds that the pooled prevalence of PMS among the studies is 47.8% with a wide range from 12% to 98% depending on the location of the study. A meta-regression shows an increasing trend in reported PMS prevalence between 1996-2011, though the correlation is not statistically significant.
#1 Premenstrual syndrome: etiology, diagnosis and treatment. A mini literature review
https://www.termedia.pl/Premenstrual-syndrome-etiology-diagnosis-and-treatment-A-mini-literature-review,113,33620,1,1.html
Premenstrual disorders consist of psychiatric or somatic symptoms that develop within the luteal phase of the menstrual cycle, affect the patients normal daily functioning, and resolve shortly after menstruation. […] During the luteal phase of the menstrual cycle, approximately 80% of women report at least one physical and psychiatric symptom; however, daily activity is not impaired in most of them. […] One study reported that approximately 36% of women had PMS, and a follow-up observation showed that these women continued to meet diagnostic criteria for PMS after 1 year. […] The severe and extreme form of PMS called premenstrual dysphoric disorder (PMDD) occurs in 38% of women. […] Studies have shown that approximately 30-50% of women experience a mild to moderate form of PMS for several days.
#1 Premenstrual syndrome (PMS)
https://womenshealth.gov/menstrual-cycle/premenstrual-syndrome
Premenstrual syndrome (PMS) is a combination of symptoms that many women get about a week or two before their period. Most women, over 90%, say they get some premenstrual symptoms, such as bloating, headaches, and moodiness. For some women, these symptoms may be so severe that they miss work or school, but other women are not bothered by milder symptoms. On average, women in their 30s are most likely to have PMS. […] As many as three in four women say they get PMS symptoms at some point in their lifetime. For most women, PMS symptoms are mild. Less than 5% of women of childbearing age get a more severe form of PMS, called premenstrual dysphoric disorder (PMDD). […] PMS symptoms may get worse as you reach your late 30s or 40s and approach menopause and are in the transition to menopause, called perimenopause. PMS stops after menopause when you no longer get a period.
#1 Prevalence, impacts and medical managements of premenstrual syndrome among female students: cross-sectional study in college of health sciences, Mekelle University, Mekelle, Northern Ethiopia | BMC Women’s Health | Full Text
https://bmcwomenshealth.biomedcentral.com/articles/10.1186/1472-6874-14-52
Premenstrual syndrome (PMS) is used to describe physical, cognitive, affective, and behavioral symptoms that occur cyclically during the luteal phase of the menstrual cycle and resolve quickly at or within a few days of the onset of menstruation. […] The prevalence of PMS according to DSM-IV was 37.0%. […] Our study revealed a high prevalence and negative impact of PMS on students of Mekelle University. […] Epidemiological surveys have estimated that the frequency of PMS symptoms is quite high about 80-90%, and about 5% of women experience severe symptoms that the symptoms interfere with their daily activities. […] The true prevalence of PMS is difficult to determine because of self-treatment, difference in availability and access to medical care, definition diagnostic criteria and cultural practices.
#1 Current Approaches in Premenstrual Syndrome Management – Bezmialem Science
https://bezmialemscience.org/articles/current-approaches-in-premenstrual-syndrome-management/doi/bas.galenos.2018.2358
This review aims to present current approaches to PMS management accompanied by international guidelines. […] The diagnosis of PMS is based on the type of symptoms and the time of emergence in the menstrual cycle. […] In order to associate the symptoms with PMS, at least one physical and psychological symptom should occur five days before menstruation, these symptoms should end four days after menstruation, they should continue at least three menstrual cycles and should adversely affect daily activities and interpersonal relationships. […] It is recommended that PMS Management be carried out gradually by a multidisciplinary team that has adopted an integrated holistic approach. […] If PSM is mild to moderate, lifestyle changes and diet causes cure and if the symptoms start to have an adverse impact on daily life pharmacological treatment is recommended.
#1 Factors Associated with Premenstrual Syndrome and its Different Symptom Domains among University Students in Lebanon
https://www.clinmedjournals.org/articles/ijwhw/international-journal-of-womens-health-and-wellness-ijwhw-4-068.php?jid=ijwhw
This study will estimate the proportion, severity and factors of PMS among Lebanese female university students. […] The prevalence of PMS, the main outcome variable in this study, was detected according to the diagnostic criteria proposed by the American College of Obstetricians and Gynecologists (ACOG). […] The symptoms must be relieved within 4 days of the onset of menses, without any recurrence until at least cycle day 13 and be present in the absence of any pharmacologic therapy or alcohol use. […] This study identified the proportion, severity and PMS associated factors among female university students in Lebanon and explored both the affective and somatic PMS domains, as well as the symptoms that accompany PMS. […] A high proportion of participants reported having PMS (62.5%).
#1 Premenstrual Syndrome (PMS) – Gynecology and Obstetrics – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/premenstrual-syndrome-pms
Symptoms of premenstrual syndrome (PMS) can be nonspecific and vary from woman to woman. […] Diagnose PMS based on symptoms alone. […] If symptoms seem severe and disabling, consider premenstrual dysphoric disorder (PMDD), which is often underdiagnosed, and ask patients to record symptoms for 2 cycles; for a diagnosis of PMDD, clinical criteria must be met. […] GnRH agonists and oophorectomy are reserved for severe cases.
#1 Premenstrual syndrome (PMS) among high school students | IJWH
https://www.dovepress.com/premenstrual-syndrome-pms-among-high-school-students-peer-reviewed-fulltext-article-IJWH
Premenstrual syndrome (PMS) is a common health problem among adolescents. […] The prevalence of PMS among adolescents varies from 10% to 53%, depending on the population studied and diagnostic measures used. […] As there have yet been no prospective studies evaluating PMS prevalence among Thai adolescents according to the recent ACOG diagnostic criteria, this study was conducted to determine the prevalence of PMS and its impacts on educational activities and interpersonal relationships among Thai adolescents in Khon Kaen, Thailand. […] The prevalence of PMS in Thai high school students in this study was ~30%. […] The notably high prevalence of PMS in Thai adolescents observed in this study warrants further large-scale study to evaluate the impact of PMS on their academic performance, quality of life, and effective interventions for alleviating PMS among this high-risk population. […] The prevalence of PMS in Thai high school students was 29.8% (95% CI, 24.5%35.4%).
#1 Premenstrual Disorders: Epidemiology and Disease Burden
https://www.ajmc.com/view/dec05-2235ps473-s479
In addition to interfering with a woman’s QOL, PMS and PMDD can have both direct and indirect economic consequences. […] It was concluded that PMS has a significant impact on a woman’s health-related QOL and may lead to reduced productivity at work and increased healthcare costs. […] It was concluded that a diagnosis of PMS was associated with modest increases in direct medical costs and a considerable increase in indirect costs stemming from missed workdays and lower productivity when the women were at work.
#1 Current Approaches in Premenstrual Syndrome Management – Bezmialem Science
https://bezmialemscience.org/articles/current-approaches-in-premenstrual-syndrome-management/doi/bas.galenos.2018.2358
Premenstrual syndrome (PMS) is a health problem that occurs with physical and psychological symptoms presenting about five days before menstruation, end within a few days after the onset of menstruation. […] PMS prevalence is notably high in the world and in our country. In this respect, it is important to increase awareness of health professionals and women about PMS. […] The prevalence of PMS was examined, Royal College of Obstetricians and Gynaecologists reported that 4 out of 10 women have premenstrual symptoms and 5-8% of them is severely affected by PMS. […] PMS is also very common in our country and especially women in young age group are reported to have a high rate (66%-91.8%) of PMS in studies. […] Given the fact that half of womens lives have passed through premenstrual period problems, it is important to raise awareness of health workers and to teach women the necessary self-care practices for PMS management.
#1 Current Approaches in Premenstrual Syndrome Management – Bezmialem Science
https://bezmialemscience.org/articles/current-approaches-in-premenstrual-syndrome-management/doi/bas.galenos.2018.2358
The first step in PMS management is to create awareness with education and consultancy, to teach women self-screening and self-care practices. […] If daily life, work life or interpersonal relationships are negatively affected, then a woman is in search of PMSs treatment. […] Although some CAT practices are known to be useful in the management of PMS, there is no advanced evidence that the majority of them are effective. […] The first option is non-hormonal therapy to increase the central seratogenic transmission, and the second option is hormonal therapy to increase the ovarian hormone level. […] PMS is a common health problem, and women spend half their life with premenstrual problems and experience a reduction in self-confidence, social isolation, decline in academic achievement, increase in accident tendency and loss of Labor. […] It is recommended to establish our national PMS management guide and to develop models in PMS management and to increase evidence-based research.
#1 A Study on Premenstrual Syndrome among Female Students of a Private University of Delhi NCR
http://www.fortunejournals.com/articles/a-study-on-premenstrual-syndrome-among-female-students-of-a-private-university-of-delhi-ncr.html
Based on the findings of the present study, it can be said that: PMS is a common problem affecting the educational activities and interpersonal relationships of female participants significantly. Although a positive attitude towards PMS was noted in our study but (40.8%) of female participants did nothing to relieve their premenstrual symptoms and only (10.8%) of them seek gynecologist to relieve their symptoms. Despite of the positive response of female participants towards PMS in our study, there is lack of knowledge about the necessity to consult a doctor or seek treatment for their symptoms. Further research is required on a larger population.
#1
https://www.ijrcog.org/index.php/ijrcog/article/view/14188
Premenstrual syndrome (PMS) is a set of distressing physical and psychological symptoms occurring cyclically during the luteal phase of each menstrual cycle that begin a few days before menstruation and resolves within a few days of the onset of menstruation. […] A total of 202 participants were part of the study of which 137 (67.8%) of them had premenstrual symptoms and of which 49 (79%) of them had a familial history of PMS. […] The prevalence of PMS is on the higher side i.e. 68.3% compared to many studies around the world. […] The health seeking behaviour knowledge about PMS seems to be quite low among the students and thereby indicates the need to provide awareness and give emphasis on the management of premenstrual symptoms both pharmacologically (if required) and non-pharmacologically.
#2 Premenstrual Syndrome – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK560698/
Premenstrual syndrome (PMS) encompasses clinically significant somatic and psychological manifestations during the luteal phase of the menstrual cycle, leading to substantial distress and impairment in functional capacity. These symptoms disappear within a few days of the onset of menstruation. The pooled prevalence of reproductive age women affected with PMS worldwide amounts to 47.8%. Among these, about 20% of women experience symptoms severe enough to disrupt their daily activities, and the remaining have mild to moderate symptoms. […] Epidemiological studies have revealed that about 80% to 90% of women manifest at least one of the PMS signs; however, in about 2.5% to 3% of women, the syndrome severe enough to affect their activities and social communications. This disorder is known as premenstrual dysphoric disorder (PMDD).
#2 Premenstrual syndrome mechanism in the brain | 2021, Volume 7 – Issue 2 | Demiroglu Science University Florence Nightingale Journal of Medicine
https://journalmeddbu.com/full-text/250
Premenstrual syndrome (PMS) is a disorder in which a set of physical, emotional, and behavioral symptoms, mostly seen in the late luteal phase of the menstrual cycle, disappear with the onset of menstruation. It has a high incidence in society, and it causes problems in a person’s daily life. […] The World Health Organization (WHO) estimated that 199 million women suffer from PMS in 2010. During their luteal phase, an estimated 80% of menstruating women around the world experience one or more PMS symptoms. […] The pooled prevalence of PMS was 47.8% in a meta-analysis study based on 17 papers, with France having the lowest prevalence at 12% and Iran having the highest at 98%. […] Premenstrual syndrome has a wide range of prevalence. The mental, neurological, and endocrine systems all have a role in the etiology of PMS.
#2 Premenstrual Syndrome: Practice Essentials, Pathophysiology and Etiology, Epidemiology
https://emedicine.medscape.com/article/953696-overview
Individual symptoms of PMS have been reported to affect as many as 90% of women of reproductive age sometime during their lives. An estimated 20-30% of women may meet criteria for PMS based on symptoms with 2-5% of women meeting symptomatic criteria for PMDD. […] Two known risk factors for PMS are obesity and smoking. Research reveals that women with a body mass index (BMI) of 30 or above are nearly three times as likely to have PMS than women who are not obese. Women who smoke cigarettes are more than twice as likely to have more severe PMS symptoms. […] Life experiences may also be a risk factor for PMS. The results of a large longitudinal study carried out by Bertone-Johnson et al suggested that the experience of abuse (emotional, sexual, or physical) in early life places women at higher risk for PMS in the middle-to-late reproductive years. […] PMS affects women with ovulatory cycles. Older adolescents tend to have more severe symptoms than younger adolescents do. Women in their fourth decade of life tend to be affected most severely. PMS resolves completely at menopause.
#2 Premenstrual syndrome, a common but underrated entity: review of the clinical literature – Journal of the Turkish-German Gynecological Association
https://www.jtgga.org/articles/premenstrual-syndrome-a-common-but-underrated-entity-review-of-the-clinical-literature/doi/jtgga.galenos.2021.2020.0133
In a study conducted at Switzerland in 2007, a total of 3,913 women aged 15 to 54 responded to a questionnaire inquiring about PMS symptoms and 3,522 (90%) reported that PMS affected their daily life. […] Also, in a meta-analysis covering 18,803 women, the overall prevalence of PMS was 47.8%. […] The authors emphasized that the prevalence of PMS was studied more in Asia than in other continents. […] A global study involving 7,226 women from South America, Europe and Asia, investigating the frequency of PMS symptoms and found the frequency to be parallel between countries and the regions, but in some countries, such as Pakistan, women were found to be less familiar with the term PMS compared to European women.
#2 Premenstrual Syndrome (PMS) – almostadoctor
https://almostadoctor.co.uk/encyclopedia/premenstrual-syndrome-pms
Premenstrual syndrome refers to a group of physical and psychological symptoms that occur in there 2-14 days before menstruation, and tend to resolve as soon as menstruation begins. […] More common after age of 30 […] Peak incidence age 30-40 […] Affects up to 50% of women […] 90% of women experience premenstrual symptoms, but only about 50% severe enough to fall under a diagnosis of PMS […] PMDD affects 2-5% of women […] History of PMS increased the likelihood of mood disorder around the time of menopause.
#2
https://link.springer.com/article/10.1007/s00737-022-01261-5
A large study of over 3500 women reported the prevalence of moderate to severe mood-based PMS as 10.7% in women aged 15-24, 8.6% in women aged 25-34, 11.2% in women aged 35-44, and 10.8% in women aged 45-54. […] However, another cross-sectional study found that premenstrual symptoms were less common in women ages 36 to 44 years, compared with younger women. […] In a meta-analysis assessing the prevalence of PMS in twelve countries, the highest prevalence was reported in Iran (98%) and the lowest prevalence was reported in France (12%). […] In a study of over 4000 women from 19 different countries, those with moderate to severe premenstrual symptoms showed increased absenteeism and decreased productivity at work. […] Among adolescents, at least 20% reported PMS symptoms associated with functional impairment.
#2 Epidemiology and Etiology of Premenstrual Syndromes
https://www.medscape.org/viewarticle/553603
Population-based studies have not consistently found strong association between PMS and standard demographic risk factors such as education, income, employment, marital status, or number of children. […] Higher levels of perceived stress and higher „daily hassles” scores have been identified as risk factors for PMS by population-based studies. […] Studies of twins have significantly contributed to data related to possible genetic factors in PMS. […] A strong association between PMS and a body mass index 30 is reported in a recent population-based study. […] Women with other health problems are more likely to have PMS. […] Current mood and anxiety disorders or history of mood or anxiety disorders are common in women with PMS.
#2 Epidemiology and pathogenesis of premenstrual syndrome and premenstrual dysphoric disorder – UpToDate
https://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder/print
Premenstrual dysphoric disorder (PMDD), as defined by the American Psychiatric Association (APA) Diagnostic and Statistical Manual, Fifth Edition (DSM-5), can be differentiated from premenstrual syndrome (PMS) by the presence of at least five symptoms, including one affective symptom, such as mood swings, irritability, and/or depression. […] The prevalence of PMS and PMDD in the population have been overestimated because of the failure to apply strict diagnostic criteria. Estimates as high as 80 percent have been reported for PMS, based upon the inclusion of females who have any form of premenstrual mood or physical symptoms. When one applies strict inclusion criteria, estimates for PMS are around 20 to 30 percent and 2 percent for PMDD, as illustrated by three community studies that used prospective ratings to determine the diagnosis.
#2 Epidemiology and Etiology of Premenstrual Syndromes
https://www.medscape.org/viewarticle/553603
Premenstrual syndrome (PMS) is characterized by significant mood, behavioral, and physical changes that occur several days to 2 weeks before menses and abate during the menstrual flow. […] Surveys indicate that PMS is among the most common health problems reported by reproductive age women. Current estimates of the prevalence of clinically significant PMS vary from 12.6% to 31% of menstruating women. […] Epidemiologic studies have identified approximately 20% of reproductive age women as having moderate to severe PMS. […] The prevalence of PMDD is estimated to affect 5% to 8% of menstruating women. […] The morbidity of PMS is due to severity of symptoms, chronicity, and the resulting emotional distress or impairment in work, relationships, and activities. […] Current clinical evidence suggests that PMS tends to be a chronic illness with little spontaneous recovery.
#2 Premenstrual syndrome mechanism in the brain | 2021, Volume 7 – Issue 2 | Demiroglu Science University Florence Nightingale Journal of Medicine
https://www.journalmeddbu.com/full-text/250
Premenstrual dysphoric disorder is a depressive disorder that affects functionality, is less common, and is listed in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5), which includes more severe PMS symptoms. […] The etiology of PMS is associated with cognitive and psychosocial learning theories. […] The factors leading to CNS malfunctions in PMS have not been entirely understood. Many symptoms of PMDD, on the other hand, are comparable to psychiatric conditions involving the serotonergic system, and the links between the serotonergic system and progesterone have focused researchers attention on serotonergic regulation. […] The involvement of the CNS in PMS is becoming clear due to an increase in brain imaging studies. […] The regulatory role of the Val158Met genotype and the investigation of the less functional variant of Val66Met were mentioned in numerous gene studies, and it was suggested that 5-HTTLPR and MAOA-uVNTR polymorphisms be investigated. […] In a study examining PMDD, changes in GM volumes were reported in the HIPP/parahippocampus and cerebellum.
#2 Premenstrual syndrome (PMS)
https://womenshealth.gov/menstrual-cycle/premenstrual-syndrome
Premenstrual syndrome (PMS) is a combination of symptoms that many women get about a week or two before their period. Most women, over 90%, say they get some premenstrual symptoms, such as bloating, headaches, and moodiness. For some women, these symptoms may be so severe that they miss work or school, but other women are not bothered by milder symptoms. On average, women in their 30s are most likely to have PMS. […] As many as three in four women say they get PMS symptoms at some point in their lifetime. For most women, PMS symptoms are mild. Less than 5% of women of childbearing age get a more severe form of PMS, called premenstrual dysphoric disorder (PMDD). […] PMS symptoms may get worse as you reach your late 30s or 40s and approach menopause and are in the transition to menopause, called perimenopause. PMS stops after menopause when you no longer get a period.
#2 Association between sleep quality and premenstrual syndrome in young women in a cross-sectional study | Scientific Reports
https://www.nature.com/articles/s41598-025-90581-4
Sleep disorders are recognized as one of the significant risk factors for premenstrual syndrome (PMS). […] The prevalence of PMS is estimated to be 48% worldwide, while in Iran it was reported to be 70.8%. […] Recent reports suggest that poor sleep quality, insomnia, and short sleep duration are related to PMS. […] The relationship between menstrual problems and poor sleep is not clear. It is uncertain whether menstrual problems cause poor sleep or if poor sleep leads to menstrual problems. […] The results indicate that 78.6% of the participants had good sleep quality, while 21.4% had poor sleep quality. […] According to the findings of this study, a significant association was observed between sleep quality and PMS and the subscales of anger, anxiety, sensitivity to negative response, depressed mood and disappointment, and fatigue. This suggests the importance of addressing sleep quality in managing PMS symptoms and underscores the potential benefits of interventions targeting improved sleep in alleviating various aspects of premenstrual syndrome.